The Florida 2010 Legislative Session started March 2 and the topic on everyone's mind is the budget. Florida is looking at a 3 billion dollar deficit, due to revenue shortfalls, that will have to be addressed. Florida legislators are Mandated to balance Florida's budget during each legislative session. Education and Human Services represent the largest share of the budget and will have to be cut.

The Governor's 2010-2011 budget was called optimistic by some and unrealistic by others. It is based on revenue sources that have not been approved and calls for leaving small reserves in the existing budget. The Senate has written to the Federal Government asking for an extension of the increased federal money that was provided in the economic stimulus package last year. This money, and revenue Through a Seminole gambling compact, will not be realized until after the regular session is over, if they are approved.

In the meantime, Senate and House appropriations committees are considering cuts in health and human services programs that could result in as much as a 15% reduction in Home and Community Based Waiver services. The initial decisions for Cutting programs are expected by March 12, 2010.

The work being done by the House is somewhat encouraging because the members of the Health Care Appropriations Committee have ranked services to people with Developmental disabilities as one of the five top services to be preserved. However, how this translates into cuts is not yet known and no program may end up being exempt from reductions.

The Senate is approaching the process of cutting differently. Like the House, they have asked state agencies to present their recommendations on cuts. However, the process is moving more slowly and members have not been openly polled.

The Agency for Persons with Developmental Disabilities (APD) has presented the following options:

On February 17, Agency for Persons with Disabilities Director Jim DeBeaugrine was required to present a 15 percent budget cutting exercise to a Senate committee. DeBeaugrine stated that he did not recommend any of the reductions to the agency's budget. He was quoted in the media in a column by Jim Saunders with Health News Florida:

"Nevertheless, Jim DeBeaugrine, director of the state Agency for Persons with Disabilities, made clear Wednesday that he didn't want to have to carry out the cuts he proposed to the Senate committee. After a lawmaker asked about the effects of one proposed cut dealing with programs that developmentally disabled people attend during the day," DeBeaugrine replied, 'In all honesty, it would be very drastic."

The elimination of Adult Day Training (ADT) and the other services grouped with it (Item 4) represents a 62% cut for these services. The other services include respite care, supported employment, supported living, and companion services. If enacted, this cut will affect 24,000 of the 29,000 people now being served under the waiver. Despite the creation of a flexible benefit service that individuals, parents and guardians can use to continue some of these services, the reality is that there will be only 38% of the money originally devoted to these services left to pay for them.

This is troubling because not only will there be more individuals idle during the day, but the two services that make up the very existence of independent living, supported living and supported employment, will be dramatically reduced, possibly threatening the existence of that living option. Also, while it is nice to have a flexible benefit, the reality is that the integrity of each of the services that make up this benefit will be eliminated as a stand-alone service.

Putting a cap on Tier One will effectively force some individuals into residential services and the elimination of behavioral assistance will affect some group homes dramatically, threatening their existence.

The Florida Developmental Disabilities Council has taken a position to avoid further cuts in waiver dollars and services.

Early Steps is administered by Children's Medical Services (CMS) in accordance with the Individuals with Disabilities Education Act (IDEA), Part C.

Early Steps, which serves children from birth to 36 months who have a developmental delay, or a condition that places them at risk for developmental delays, provides Florida's infants and toddlers early-intervention services and supports intended to improve children's chances to develop to their full potential by achieving specific developmental milestones. These milestones are essential to the development of a child's ability to learn, speak, and move at critical periods that research shows lead to optimal abilities in later life.

For the 2010-11 fiscal year, a projected shortfall of about $4.5 million dollars could jeopardize the federal government's ability to provide a grant to Florida. The shortfall would result in a loss of funding from the state to continue a meaningful program, and the state could lose this $54 million early-intervention program.

Research has proven that the biggest impact on a child's health and functioning is in the child's early years. Longitudinal studies have documented the savings to society in the long run by taking care of our youngest citizens now.

The Council encourages lawmakers to adequately fund the Part C Early Steps program to effectively serve all children with a developmental delay.

We will be contacting members of the Health and Human Services Appropriations committee in the Senate and the Health Care Appropriations Committee in the House and we will let them know that the state needs 4.5 million dollars to maintain Early
Steps at the current level or risk losing our federal grant to provide services critical to the health and functioning of all children ages 0-36 months who have a developmental delay.

Intentional Communities

Senator Altman and Representative Stargel have filed identical bills, SB 1166 and HB 645, that would do the following: eliminate the 1,000 foot rule for group homes within a planned residential community for individuals with developmental disabilities; allow the local government to consider certain criteria, such as land use, zoning and building codes, in determining approval of the community; prohibit local government from considering the proximity of the group homes in the community; and requires that rulemaking for the Agency for Persons with Disability not limit the number of group homes that can be located in the planned residential community. The Senate bill was heard and passed in the Senate Community Affairs Committee on Tuesday, February 16th.

The Florida Developmental Disabilities Council invested a considerable amount of effort this past summer learning about this issue, including listening to families who want planned residential communities (also referred to as intentional communities), learning about intentional communities, visiting an intentional community in Florida, and gaining an understanding of the implication of state and federal requirements on intentional communities. We recognize that the current living arrangements for adults with developmental disabilities who wish or need to live outside of their families' homes often do not adequately provide for safety, social connections, full belonging in the community, affordable housing, ability to move about their neighborhood freely, continuity, and life- long sustainability. The Council adopted a position. http://www.fddc.org/sites/default/files/file/legislative_action/Intentional%20Communities.pdf that included its acknowledgement that intentional communities, designed to meet the unique needs of individuals with developmental disabilities, can offer a framework for creating greater choice of living arrangements; for bringing together the community supports and services to address many of the current issues; for enhancing choice, control, and responsibility in all aspects of life; and for maintaining full inclusion in the community.

While acknowledging the potential benefits intentional communities can offer, the Council also strongly supports the values that have been inherent in the intent of the federal Home and Community Based Waiver funds. The Council therefore believes that Waiver funds should be used for Intentional Communities when the following characteristics are present:

· Provides for housing options only - no workshops, day training, or common
dining is provided on-site;

· Ensures easy access to the broader community;

· Encourages the broader community to come into the Intentional Community;

· Ensures that individuals with developmental disabilities create their own
daily schedules and activities;

· Ensures that individuals with developmental disabilities choose their own
supports and providers;

· Offers housing that is affordable;

· Provides special safety features; and

· Includes residents who are both individuals with disabilities (i.e., developmental disabilities and other disabilities) and individuals without disabilities in a sufficient mix so as not to create a segregated community.

The Florida Developmental Disabilities Council is working with other organizations to amend the House and Senate bills to require through rulemaking the presence of these characteristics when wavier funds are used in Planned (or intentional) ommunities. The Council is concerned that community integration, independence, choice in daily living, and full access to community services as intended with Waiver funds will be jeopardized without such requirements.
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This bill prohibits rules adopted by the Agency for Persons with Disabilities from restricting the number of facilities designated as community residential homes located within a planned residential community. The bill also defines the term "planned residential community" and provides that community residential homes located within a planned residential community may be contiguous to one another and exempt from the 1000 foot rule. The 1000 foot rule states that group homes that have six beds or less may not be within 1000 feet of each other. EFFECTIVE DATE: 07/01/2010.

This bill amends provisions in statute by substituting the term "intellectual disability" for the term "mental retardation." The bill revises definitions relating to intermediate care facilities for the developmentally disabled to delete unused terms. The bill also provides that the name Arc of Florida is substituted for the Association for Retarded Citizens. This bill is a "reviser bill". It provides a directive to the Division of Statutory Revision. EFFECTIVE DATE: 07/01/2010.

This bill provides that manual physical restraint shall be used only in an emergency
when there is imminent risk of serious injury or death to the student or others; it provides restrictions on the use of manual physical restraint and prohibits the use of manual physical restraint by school personnel who are not trained and certified to use district-approved methods for applying restraint techniques. The bill prohibits school personnel from placing a student in seclusion and provides requirements for use of time-out. It requires schools to prepare an incident report after an occasion of student restraint and also requires development and revision of school district policies and procedures. The Council has taken a position supporting this legislation http://www.fddc.org/sites/default/files/file/news/RestraintSeclusion2010.pdf

- Relating to Medicaid Buy-in Program/Persons with Disabilities by Crist

Summary:

The bill provides for Medicaid eligibility for certain persons with disabilities under a Medicaid buy-in program, subject to specific federal authorization. The proposed Work Incentive Medicaid Coverage program would continue to offer Medicaid coverage to people with disabilities who are working. Once they enrolled in the program they would have the opportunity to earn more and save more than the allowable limits for regular Medicaid and still retain their health care coverage through the State's Medicaid Program. The bill requires the Department of Children and Family Services to adopt rules for determining eligibility. The bill also directs the Department of Health to perform all disability determinations. Finally, the bill requires the Agency for Healthcare Administration to seek amendments to specified Medicaid waivers for certain persons with disabilities. The Council supports this legislation.

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